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Traumatic Great Vessel Injuries In Children: A 10-Year Experience Of A Pediatric Intensive Care Unit In A Tertiary
Inês Teixeira1, Marta Grilo2, Maria José Oliveira2
1Serviço de Cirurgia Pediátrica, ULS Gaia Espinho, Portugal.
Insights
Traumatic great vessel injuries are rare but life-threatening in children. Early recognition and treatment are crucial for survival, with no deaths or complications reported in this pediatric case series.
Area of Science:
- Pediatric Critical Care Medicine
- Trauma Surgery
- Vascular Surgery
Background:
- Traumatic great vessel injuries are rare, severe, and life-threatening, particularly in pediatric patients.
- Road traffic crashes are a primary cause of these injuries in Europe.
- Management strategies for pediatric traumatic great vessel injuries are not well-established.
Purpose of the Study:
- To present a case series of pediatric patients with traumatic great vessel injuries.
- To review management approaches and clinical outcomes in the literature.
- To highlight the importance of early recognition and treatment in improving survival rates.
Main Methods:
- Retrospective review of trauma patients under 18 years old admitted to a tertiary Pediatric Intensive Care Unit (PICU) from 2012 to 2021.
- Collection and analysis of demographic and clinical data, including injury severity and treatment outcomes.
- Literature review of approaches and outcomes for similar pediatric cases.
Main Results:
- Four pediatric cases (1.5%) of traumatic great vessel injuries were identified among 260 trauma admissions.
- The majority of patients were male (75%), with a mean age of 15.5 years, primarily due to blunt thoracoabdominal trauma from road traffic crashes.
- All patients underwent emergent surgery, with a mean PICU stay of 24.7 days; no major vessel complications or deaths were observed during a median follow-up of 71 months.
Conclusions:
- Traumatic great vessel injuries in children are rare, severe, and challenging to diagnose, emphasizing the need for prompt identification and intervention.
- Effective management and early treatment are critical for improving survival outcomes in pediatric patients.
- Prevention efforts targeting high-speed accidents and violence among adolescents are essential and require multi-sectoral collaboration.
Background:
Traumatic injuries of the great vessels are rare but life-threatening in most cases. Road traffic crashes are the main cause of preventable traumatic injuries in Europe, namely great vessel injuries. Management of this condition in the pediatric population is poorly established and documented. We present our experience in assisting traumatic patients with traumatic great vessel injuries at a tertiary center Pediatric Intensive Care Unit. We also reviewed the approaches and clinical outcomes reported in the literature on behalf of this case series.
Methods:
We conducted a retrospective review of traumatic injuries reported from 2012 to 2021 at our Pediatric Intensive Care Unit. Patients under 18 years old who were victims of traumatic great vessel injuries were selected. Demographic and clinical data from these patients were collected until September of 2025 and analyzed.
Results:
Of the 260 trauma patients admitted to the Pediatric Intensive Care Unit, there were 4 (1.5%) cases of traumatic great vessel injuries associated with trauma. Three patients (75%) were male, and the mean age was 15.5 ± 1.7 years (range 13-17). The mechanism of trauma was blunt thoracoabdominal trauma from road traffic crashes in 3 patients and an abdominal stab wound due to aggression in 1 patient. The mean Modified Injury Severity Score and standard deviation were 15.5 ± 0.9. All patients required emergent surgery at hospital admission. The mean PICU stay and standard deviation were 24.7 ± 7.8 days. The median follow-up period was 71 (51-158) months. No major vessel complications or deaths were identified.
Conclusion:
Traumatic great vessel injuries are rare, severe, and difficult to diagnose in children; however, early recognition and treatment are essential to improve survival. Prevention of trauma resulting from high-speed accidents and domestic violence among adolescents must be promoted by healthcare services, as well as by authorities and social and political entities.
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